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Dolivo DM, Reed CR, Gargiulo KA, Rodrigues AE, Galiano RD, Mustoe TA, Hong SJ. Anti-fibrotic effects of statin drugs: a review of evidence and mechanisms. Biochem Pharmacol 2023:115644. [PMID: 37321414 DOI: 10.1016/j.bcp.2023.115644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 06/17/2023]
Abstract
Fibrosis is a pathological repair process common among organs, that responds to damage by replacement of tissue with non-functional connective tissue. Despite the widespread prevalence of tissue fibrosis, manifesting in numerous disease states across myriad organs, therapeutic modalities to prevent or alleviate fibrosis are severely lacking in quantity and efficacy. Alongside development of new drugs, repurposing of existing drugs may be a complementary strategy to elect anti-fibrotic compounds for pharmacologic treatment of tissue fibrosis. Drug repurposing can provide key advantages to de novo drug discovery, harnessing the benefits of previously elucidated mechanisms of action and already existing pharmacokinetic profiles. One class of drugs a wealth of clinical data and extensively studied safety profiles is the statins, a class of antilipidemic drugs widely prescribed for hypercholesterolemia. In addition to these widely utilized lipid-lowering effects, increasing data from cellular, pre-clinical mammalian, and clinical human studies have also demonstrated that statins are able to alleviate tissue fibrosis originating from a variety of pathological insults via lesser-studied, pleiotropic effects of these drugs. Here we review literature demonstrating evidence for direct effects of statins antagonistic to fibrosis, as well as much of the available mechanistic data underlying these effects. A more complete understanding of the anti-fibrotic effects of statins may enable a clearer picture of their anti-fibrotic potential for various clinical indications. Additionally, more lucid comprehension of the mechanisms by which statins exert anti-fibrotic effects may aid in development of novel therapeutic agents that target similar pathways but with greater specificity or efficacy.
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Affiliation(s)
- David M Dolivo
- Department of Surgery-Northwestern University Feinberg School of Medicine, United States.
| | - Charlotte R Reed
- Department of Surgery-Northwestern University Feinberg School of Medicine, United States
| | - Kristine A Gargiulo
- Department of Surgery-Northwestern University Feinberg School of Medicine, United States
| | - Adrian E Rodrigues
- Department of Surgery-Northwestern University Feinberg School of Medicine, United States
| | - Robert D Galiano
- Department of Surgery-Northwestern University Feinberg School of Medicine, United States
| | - Thomas A Mustoe
- Department of Surgery-Northwestern University Feinberg School of Medicine, United States
| | - Seok Jong Hong
- Department of Surgery-Northwestern University Feinberg School of Medicine, United States.
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2
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Yu YD, Xue YT, Li Y. Identification and verification of feature biomarkers associated in heart failure by bioinformatics analysis. Sci Rep 2023; 13:3488. [PMID: 36859608 PMCID: PMC9977868 DOI: 10.1038/s41598-023-30666-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 02/28/2023] [Indexed: 03/03/2023] Open
Abstract
Heart failure is the final destination of most cardiovascular diseases, and its complex molecular mechanisms remain largely uncertain. This study aimed to systematically investigate the underlying molecular mechanisms and diagnostic and therapeutic targets of heart failure using bioinformatics. We obtained 8 healthy samples and 8 heart failure samples from GSE8331 and GSE76701. After removing the batch effect, we performed a differential analysis on it and obtained 185 differentially expressed ID. The results of enrichment analysis showed that the molecular mechanisms of heart failure were mostly related to immune, inflammation, and metabolism-related pathways. Immune cell infiltration analysis showed that the degree of infiltration of Tgd cells and Neurons was significantly enriched in heart failure samples, whereas pDCs and NKTs were in healthy tissue samples. We obtained Hub genes including EGR1, EGR2, FOS and FOSB by PPI network analysis. We established a 4-gene diagnostic model with Hub gene, and validated it in GSE21610 and GSE57338, and evaluated the discriminative ability of Hub gene by ROC curve. The 4-gene diagnostic model has an AUC value of 0.775 in GSE21610 and 0.877 in GSE57338. In conclusion, we explored the underlying molecular mechanisms of heart failure and the immune cell infiltration environment of failing myocardium by performing bioinformatic analysis of the GEO dataset. In addition, we identified EGR1, EGR2, FOS and FOSB as potential diagnostic biomarkers and therapeutic targets for heart failure. More importantly, a diagnostic model of heart failure based on these 4 genes was developed, which leads to a new understanding of the pathogenesis of heart failure and may be an interesting target for future in-depth research.
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Affiliation(s)
- Yi-ding Yu
- grid.464402.00000 0000 9459 9325Shandong University of Traditional Chinese Medicine, Jinan, 250014 China
| | - Yi-tao Xue
- grid.479672.9Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250014 China
| | - Yan Li
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250014, China.
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3
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Umbarkar P, Tousif S, Singh AP, Anderson JC, Zhang Q, Tallquist MD, Woodgett J, Lal H. Fibroblast GSK-3α Promotes Fibrosis via RAF-MEK-ERK Pathway in the Injured Heart. Circ Res 2022; 131:620-636. [PMID: 36052698 PMCID: PMC9481711 DOI: 10.1161/circresaha.122.321431] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Heart failure is the leading cause of mortality, morbidity, and health care expenditures worldwide. Numerous studies have implicated GSK-3 (glycogen synthase kinase-3) as a promising therapeutic target for cardiovascular diseases. GSK-3 isoforms seem to play overlapping, unique and even opposing functions in the heart. Previously, we have shown that of the 2 isoforms of GSK-3, cardiac fibroblast GSK-3β acts as a negative regulator of myocardial fibrosis in the ischemic heart. However, the role of cardiac fibroblast-GSK-3α in the pathogenesis of cardiac diseases is completely unknown. METHODS To define the role of cardiac fibroblast-GSK-3α in myocardial fibrosis and heart failure, GSK-3α was deleted from fibroblasts or myofibroblasts with tamoxifen-inducible Tcf21- or Postn-promoter-driven Cre recombinase. Control and GSK-3α KO mice were subjected to cardiac injury and heart parameters were evaluated. The fibroblast kinome mapping was carried out to delineate molecular mechanism followed by in vivo and in vitro analysis. RESULTS Fibroblast-specific GSK-3α deletion restricted fibrotic remodeling and preserved function of the injured heart. We observed reductions in cell migration, collagen gel contraction, α-SMA protein levels, and expression of ECM genes in TGFβ1-treated KO fibroblasts, indicating that GSK-3α is required for myofibroblast transformation. Surprisingly, GSK-3α deletion did not affect SMAD3 activation, suggesting the profibrotic role of GSK-3α is SMAD3 independent. The molecular studies confirmed decreased ERK signaling in GSK-3α-KO CFs. Conversely, adenovirus-mediated expression of a constitutively active form of GSK-3α (Ad-GSK-3αS21A) in fibroblasts increased ERK activation and expression of fibrogenic proteins. Importantly, this effect was abolished by ERK inhibition. CONCLUSIONS GSK-3α-mediated MEK-ERK activation is a critical profibrotic signaling circuit in the injured heart, which operates independently of the canonical TGF-β1-SMAD3 pathway. Therefore, strategies to inhibit the GSK-3α-MEK-ERK signaling circuit could prevent adverse fibrosis in diseased hearts.
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Affiliation(s)
- Prachi Umbarkar
- Division of Cardiovascular Disease, The University of Alabama at Birmingham, AL 35294-1913, USA
| | - Sultan Tousif
- Division of Cardiovascular Disease, The University of Alabama at Birmingham, AL 35294-1913, USA
| | - Anand P. Singh
- Division of Cardiovascular Disease, The University of Alabama at Birmingham, AL 35294-1913, USA
| | - Joshua C. Anderson
- Department of Radiation Oncology, The University of Alabama at Birmingham, AL 35294-1913, USA
| | - Qinkun Zhang
- Division of Cardiovascular Disease, The University of Alabama at Birmingham, AL 35294-1913, USA
| | | | - James Woodgett
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada
| | - Hind Lal
- Division of Cardiovascular Disease, The University of Alabama at Birmingham, AL 35294-1913, USA
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Khan S, Rasool ST. Current Use of Cardiac Biomarkers in Various Heart Conditions. Endocr Metab Immune Disord Drug Targets 2021; 21:980-993. [PMID: 32867665 DOI: 10.2174/1871530320999200831171748] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 08/07/2020] [Accepted: 08/07/2020] [Indexed: 01/08/2023]
Abstract
Biomarkers are increasingly recognized to have significant clinical value in early identification and progression of various cardiovascular diseases. There are many heart conditions, such as congestive heart failure (CHF), ischemic heart diseases (IHD), and diabetic cardiomyopathy (DCM), and cardiac remodeling, in which the severity of the cardiac pathology can be mirrored through these cardiac biomarkers. From the emergency department (ED) evaluation of acute coronary syndromes (ACS) or suspected acute myocardial infarction (AMI) with cardiac marker Troponin to the diagnosis of chronic conditions like Heart Failure (HF) with natriuretic peptides, like B-type natriuretic peptide (BNP), N-terminal pro-B- type natriuretic peptide (Nt-proBNP) and mid regional pro-atrial natriuretic peptide (MR- proANP), their use is continuously increasing. Their clinical importance has led to the discovery of newer biomarkers, such as the soluble source of tumorigenicity 2 (sST2), galectin-3 (Gal-3), growth differentiation factor-15 (GDF-15), and various micro ribonucleic acids (miRNAs). Since cardiac pathophysiology involves a complex interplay between inflammatory, genetic, neurohormonal, and biochemical levels, these biomarkers could be enzymes, hormones, and biologic substances showing cardiac injury, stress, and malfunction. Therefore, multi-marker approaches with different combinations of novel cardiac biomarkers, and continual assessment of cardiac biomarkers are likely to improve cardiac risk prediction, stratification, and overall patient wellbeing. On the other hand, these biomarkers may reflect coexisting or isolated disease processes in different organ systems other than the cardiovascular system. Therefore, knowledge of cardiac biomarkers is imperative. In this article, we have reviewed the role of cardiac biomarkers and their use in the diagnosis and prognosis of various cardiovascular diseases from different investigations conducted in recent years.
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Affiliation(s)
- Shahzad Khan
- Department of Pathophysiology, Wuhan University School of Medicine, Hubei, Wuhan 4300711, China
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5
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Lau K, Malik A, Foroutan F, Buchan TA, Daza JF, Sekercioglu N, Orchanian-Cheff A, Alba AC. Resting Heart Rate as an Important Predictor of Mortality and Morbidity in Ambulatory Patients With Heart Failure: A Systematic Review and Meta-Analysis. J Card Fail 2020; 27:349-363. [PMID: 33171294 DOI: 10.1016/j.cardfail.2020.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 10/30/2020] [Accepted: 11/04/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Resting heart rate is a risk factor of adverse heart failure outcomes; however, studies have shown controversial results. This meta-analysis evaluates the association of resting heart rate with mortality and hospitalization and identifies factors influencing its effect. METHODS AND RESULTS We systematically searched electronic databases in February 2019 for studies published in 2005 or before that evaluated the resting heart rate as a primary predictor or covariate of multivariable models of mortality and/or hospitalization in adult ambulatory patients with heart failure. Random effects inverse variance meta-analyses were performed to calculate pooled hazard ratios. The Grading of Recommendations, Assessment, Development and Evaluation approach was used to assess evidence quality. Sixty-two studies on 163,445 patients proved eligible. Median population heart rate was 74 bpm (interquartile range 72-76 bpm). A 10-bpm increase was significantly associated with increased risk of all-cause mortality (hazard ratio 1.10, 95% confidence interval 1.08-1.13, high quality). Overall, subgroup analyses related to patient characteristics showed no changes to the effect estimate; however, there was a strongly positive interaction with age showing increasing risk of all-cause mortality per 10 bpm increase in heart rate. CONCLUSIONS High-quality evidence demonstrates increasing resting heart rate is a significant predictor of all-cause mortality in ambulatory patients with heart failure on optimal medical therapy, with consistent effect across most patient factors and an increased risk trending with older age.
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Affiliation(s)
- Kimberley Lau
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Abdullah Malik
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Farid Foroutan
- McMaster University, Hamilton, Ontario, Canada; Ted Rogers Centre for Heart Research, University Health Network, Toronto, Ontario, Canada
| | - Tayler A Buchan
- Ted Rogers Centre for Heart Research, University Health Network, Toronto, Ontario, Canada
| | | | | | - Ani Orchanian-Cheff
- Library and Information Services, University Health Network, Toronto, Ontario, Canada
| | - Ana C Alba
- Ted Rogers Centre for Heart Research, University Health Network, Toronto, Ontario, Canada.
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Köse O, Kurt Bayrakdar S, Akyıldız K, Altın A, Arabacı T, Yemenoglu H, Zihni Korkmaz M, Köse TE, Türker Sener L, Mercantepe T, Tümkaya L, Yılmaz A. Melatonin ameliorates periodontitis-related inflammatory stress at cardiac left ventricular tissues in rats. J Periodontol 2020; 91:1486-1494. [PMID: 32279321 DOI: 10.1002/jper.19-0685] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/28/2020] [Accepted: 03/15/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND The aim of this experimental rat study was to investigate the potential inflammatory effects of periodontitis on cardiac left ventricular tissue and the therapeutic activity of melatonin on these effects. METHODS Twenty-four male Sprague-Dawley rats were randomly divided into three groups: control, experimental periodontitis (Ep), and Ep-melatonin (Ep-Mel). Experimental periodontitis was induced by placing and maintaining 3.0 silk ligatures at a peri marginal position on the left and right mandibular first molars for 5 weeks. Afterward, following the removal of ligatures, melatonin (10 mg/body weight) to Ep-Mel group, and vehicle (saline) to Ep and control groups were administered intraperitoneally for 14 days. On the first day of the eighth week, mandibular and cardiac left ventricular tissue samples were obtained following the euthanasia of the rats in all groups. Alveolar bone loss measurements were made on histological and microcomputed tomographic slices. Cardiac tissue levels of malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), matrix metalloproteinase-9 (MMP-9), and cardiac Troponin-T (cTnT) were evaluated by appropriate biochemical methods. RESULTS Measurements made on the histological and microcomputed tomographic slices showed that melatonin significantly limits the ligature-induced periodontal tissue destruction (P <0.01). In addition, melatonin was detected to cause a significant decrease of MDA, MMP-9, and cTnT levels which were found to be significantly higher on rats with Ep (P <0.05) while having no significant effect on antioxidant levels (GSH, SOD, and CAT) (P >0.05). CONCLUSION Melatonin might be regarded as an important supportive therapeutic agent to reduce the early degenerative changes and possible hypertrophic remodeling at cardiac left ventricular tissues provoked by periodontitis-related bacteria and/or periodontal inflammation.
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Affiliation(s)
- Oğuz Köse
- School of Dentistry, Department of Periodontology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Sevda Kurt Bayrakdar
- School of Dentistry, Department of Periodontology, Eskişehir Osmangazi University, Eskisehir, Turkey
| | - Kerimali Akyıldız
- School of Healh Care Services Vocational, Department of Medical Services and Techniques, Recep Tayyip Erdogan University, Rize, Turkey
| | - Ahmet Altın
- School of Dentistry, Department of Periodontology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Taner Arabacı
- School of Dentistry, Department of Periodontology, Ataturk University, Erzurum, Turkey
| | - Hatice Yemenoglu
- School of Dentistry, Department of Periodontology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Meltem Zihni Korkmaz
- School of Dentistry, Department of Periodontology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Taha Emre Köse
- School of Dentistry, Department of Dentomaxillofacial Radiology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Leyla Türker Sener
- School of Medicine, Department of Biophysics, Istanbul University, Istanbul, Turkey
| | - Tolga Mercantepe
- School of Medicine, Department of Histology and Embryology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Levent Tümkaya
- School of Medicine, Department of Histology and Embryology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Adnan Yılmaz
- School of Medicine, Department of Biochemistry, Recep Tayyip Erdogan University, Rize, Turkey
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Täger T, Wiebalck C, Fröhlich H, Corletto A, Katus HA, Frankenstein L. Biological variation of extracellular matrix biomarkers in patients with stable chronic heart failure. Clin Res Cardiol 2017; 106:974-985. [PMID: 28779229 DOI: 10.1007/s00392-017-1147-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 07/31/2017] [Indexed: 01/21/2023]
Abstract
BACKGROUND Extracellular matrix (ECM) biomarkers such as matrix metalloproteinases (MMPs) and their inhibitors (TIMPs) are pathophysiological key, prognostic marker and therapeutic target in chronic heart failure (HF). Serial measurements of MMPs and TIMPs may be useful for guidance of these applications. However, interpretation of time-dependent changes requires knowledge about the biological variation of ECM biomarkers. METHODS We performed measurements of MMP-2, MMP-9, TIMP-1, and TIMP-4 in 50 patients with chronic HF who met rigid criteria for clinical stability at 3-h, 6-h, 1-week and 2-week time intervals. In addition, clinical and haemodynamic assessment was performed at baseline, at 1- and 2-week intervals. Haemodynamic variables were measured using inert gas rebreathing and impedance cardiography. Heart rhythm was monitored with external ECG event recorders throughout the complete study. Reference change values (RCVs) and minimal important differences (MIDs) were determined for MMP-2, MMP-9, TIMP-1, and TIMP-4. RESULTS Clinical and haemodynamic variables were stable over time. Depending on the time-interval, RCVs ranged between 4.9 and 11.7% for MMP-2, 26.4 and 56.7% for MMP-9, 10.8 and 30.7% for TIMP-1, and 16.0 and 47.4% for TIMP-4, respectively. The MIDs varied between 43.38 and 65.22 ng/ml for MMP-2, 28.71 and 40.96 ng/ml for MMP-9, 52.32 and 156.07 ng/ml for TIMP-1, and 293.92 and 798.04 pg/ml for TIMP-4, respectively. CONCLUSION The biological variation of ECM biomarkers differs with respect to individual biomarkers and time intervals. MMP-2 may be most suitable for serial biomarker measurements, as the biological variation is low irrespective of the time interval between measurements.
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Affiliation(s)
- Tobias Täger
- Department of Cardiology, Angiology, and Pulmonology, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Clara Wiebalck
- Department of Cardiology, Angiology, and Pulmonology, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Hanna Fröhlich
- Department of Cardiology, Angiology, and Pulmonology, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Anna Corletto
- Department of Cardiology, Angiology, and Pulmonology, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Hugo A Katus
- Department of Cardiology, Angiology, and Pulmonology, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Lutz Frankenstein
- Department of Cardiology, Angiology, and Pulmonology, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
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Guo Y, Gupte M, Umbarkar P, Singh AP, Sui JY, Force T, Lal H. Entanglement of GSK-3β, β-catenin and TGF-β1 signaling network to regulate myocardial fibrosis. J Mol Cell Cardiol 2017; 110:109-120. [PMID: 28756206 DOI: 10.1016/j.yjmcc.2017.07.011] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 07/20/2017] [Accepted: 07/24/2017] [Indexed: 12/31/2022]
Abstract
Nearly every form of the heart disease is associated with myocardial fibrosis, which is characterized by the accumulation of activated cardiac fibroblasts (CFs) and excess deposition of extracellular matrix (ECM). Although, CFs are the primary mediators of myocardial fibrosis in a diseased heart, in the traditional view, activated CFs (myofibroblasts) and resulting fibrosis were simply considered the secondary consequence of the disease, not the cause. Recent studies from our lab and others have challenged this concept by demonstrating that fibroblast activation and fibrosis are not simply the secondary consequence of a diseased heart, but are crucial for mediating various myocardial disease processes. In regards to the mechanism, the vast majority of literature is focused on the direct role of canonical SMAD-2/3-mediated TGF-β signaling to govern the fibrogenic process. Herein, we will discuss the emerging role of the GSK-3β, β-catenin and TGF-β1-SMAD-3 signaling network as a critical regulator of myocardial fibrosis in the diseased heart. The underlying molecular interactions and cross-talk among signaling pathways will be discussed. We will primarily focus on recent in vivo reports demonstrating that CF-specific genetic manipulation can lead to aberrant myocardial fibrosis and sturdy cardiac phenotype. This will allow for a better understanding of the driving role of CFs in the myocardial disease process. We will also review the specificity and limitations of the currently available genetic tools used to study myocardial fibrosis and its associated mechanisms. A better understanding of the GSK-3β, β-catenin and SMAD-3 signaling network may provide a novel therapeutic target for the management of myocardial fibrosis in the diseased heart.
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Affiliation(s)
- Yuanjun Guo
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, 2220 Pierce Ave, PRB, Suite#348, Nashville, TN 37232, United States
| | - Manisha Gupte
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, 2220 Pierce Ave, PRB, Suite#348, Nashville, TN 37232, United States
| | - Prachi Umbarkar
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, 2220 Pierce Ave, PRB, Suite#348, Nashville, TN 37232, United States
| | - Anand Prakash Singh
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, 2220 Pierce Ave, PRB, Suite#348, Nashville, TN 37232, United States
| | - Jennifer Y Sui
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, 2220 Pierce Ave, PRB, Suite#348, Nashville, TN 37232, United States
| | - Thomas Force
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, 2220 Pierce Ave, PRB, Suite#348, Nashville, TN 37232, United States
| | - Hind Lal
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, 2220 Pierce Ave, PRB, Suite#348, Nashville, TN 37232, United States.
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Stempien-Otero A, Farris S. What Can We Learn From Children? J Card Fail 2017; 23:325-326. [DOI: 10.1016/j.cardfail.2017.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 02/17/2017] [Accepted: 02/17/2017] [Indexed: 10/20/2022]
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10
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Mansour IN, Bress AP, Groo V, Ismail S, Wu G, Patel SR, Duarte JD, Kittles RA, Stamos TD, Cavallari LH. Circulating Procollagen Type III N-Terminal Peptide and Mortality Risk in African Americans With Heart Failure. J Card Fail 2015; 22:692-9. [PMID: 26721774 DOI: 10.1016/j.cardfail.2015.12.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 12/08/2015] [Accepted: 12/14/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Procollagen type III N-terminal peptide (PIIINP) is a biomarker of cardiac fibrosis that is associated with heart failure prognosis in whites. Its prognostic significance in African Americans is unknown. We sought to determine whether PIIINP is associated with outcomes in African Americans with heart failure. METHODS AND RESULTS Blood was collected from 138 African Americans with heart failure for determining PIIINP and genetic ancestry, and patients were followed prospectively for death or hospitalization for heart failure. PIIINP was inversely correlated with West African ancestry (R(2) = 0.061; P = .010). PIIINP > 4.88 ng/mL was associated with all-cause mortality on univariate (hazard ratio [HR] 4.9, 95% confidence interval [CI] 2.2-11.0; P < .001) and multivariate (HR 5.8; 95% CI 1.9-17.3; P = .002) analyses over a median follow-up period of 3 years. We also observed an increased risk for the combined outcome of all-cause mortality or hospitalization for heart failure with PIIINP > 4.88 ng/mL on univariate (HR 2.6, 95% CI 1.6-5.0; P < .001) and multivariate (HR 2.4, 95% CI 1.2-4.7; P = .016) analyses. CONCLUSIONS High circulating PIIINP is associated with poor outcomes in African Americans with chronic heart failure, suggesting that PIIINP may be useful in identifying African Americans who may benefit from additional therapy to combat fibrosis as a means of improving prognosis.
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Affiliation(s)
- Ibrahim N Mansour
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Adam P Bress
- Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, Illinois
| | - Vicki Groo
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois; Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, Illinois
| | - Sahar Ismail
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Grace Wu
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Shitalben R Patel
- Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, Illinois
| | - Julio D Duarte
- Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, Illinois
| | - Rick A Kittles
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Thomas D Stamos
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Larisa H Cavallari
- Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, Illinois.
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11
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Chalikias GK, Tziakas DN. Biomarkers of the extracellular matrix and of collagen fragments. Clin Chim Acta 2015; 443:39-47. [DOI: 10.1016/j.cca.2014.06.028] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Revised: 06/15/2014] [Accepted: 06/27/2014] [Indexed: 02/06/2023]
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12
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Procollagen type III amino-terminal propeptide: a serum biomarker of left ventricular remodelling in paediatric dilated cardiomyopathy. Cardiol Young 2015; 25:228-36. [PMID: 24192074 DOI: 10.1017/s1047951113001820] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Procollagen type III amino-terminal propeptide is a collagen III cleavage product released in blood. The serum levels of this propeptide in adults with dilated cardiomyopathy are associated with cardiac remodelling and prognosis. The utility of procollagen type III amino-terminal propeptide as a biomarker in paediatric dilated cardiomyopathy is unknown. METHODS This was a prospective, longitudinal study of children with dilated cardiomyopathy and changes in procollagen type III amino-terminal propeptide. The serum level of propeptide was measured serially, compared with paediatric normal values, and correlated with clinical status and left ventricular size and function on echocardiograms and cardiac magnetic resonance imaging. RESULTS Procollagen type III amino-terminal propeptide was measured serially in 149 samples from 39 patients, age 9.0±6.4 years, followed up for 16.8±16.3 months. Procollagen type III amino-terminal propeptide in dilated cardiomyopathy was higher than in normal children. On multivariate analyses, procollagen type III amino-terminal propeptide had a positive correlation with left ventricular dilation, left ventricular end-diastolic diameter index (p<0.0001), and left ventricular end-diastolic diameter Z-score (p=0.0003), and a negative correlation with shortening fraction changes over time (p=0.001). Patients with myocarditis (n=12) had higher procollagen type III amino-terminal propeptide values than those with idiopathic dilated cardiomyopathy (n=20). CONCLUSIONS Procollagen type III amino-terminal propeptide increases with left ventricular dilation and decreases with improvement in systolic function in paediatric dilated cardiomyopathy, indicating a role as a biomarker of cardiac remodelling in children. The diagnostic utility of procollagen type III amino-terminal propeptide to differentiate myocarditis from idiopathic dilated cardiomyopathy warrants further investigation.
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Dörr O, Liebetrau C, Möllmann H, Mahfoud F, Ewen S, Gaede L, Troidl C, Hoffmann J, Busch N, Laux G, Wiebe J, Bauer T, Hamm C, Nef H. Beneficial effects of renal sympathetic denervation on cardiovascular inflammation and remodeling in essential hypertension. Clin Res Cardiol 2014; 104:175-84. [PMID: 25326158 DOI: 10.1007/s00392-014-0773-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 10/14/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Renal sympathetic denervation (RSD) represents a potential treatment option for certain patients with resistant arterial hypertension (HT). HT is associated with chronic vascular inflammation and remodeling, contributing to progressive vascular damage, and atherosclerosis. The present study aimed to evaluate the influence of RSD on cardiovascular inflammation and remodeling by determining serum levels of interleukin-6 (IL-6), high-sensitive C-reactive protein (hsCRP), matrix metalloproteinases (MMP), and tissue inhibitor of metalloproteinases (TIMP). METHODS A total of 60 consecutive patients (age 67.9 ± 9.6 years) undergoing RSD were included. A therapeutic response was defined as an office systolic blood pressure (SBP) reduction of >10 mmHg 6 months after RSD. Venous serum samples for measurement of hsCRP, IL-6, MMP-2, MMP-9, and TIMP-1 were collected prior to and 6 months after RSD. RESULTS A significant reduction in office SBP of 26.4 mmHg [SBPbaseline 169.3 mmHg (SD 11.3), p < 0.001] was documented 6 months after RSD. The serum levels of hsCRP (p < 0.001) and the pro-inflammatory cytokine IL-6 (p < 0.001) were significantly decreased compared to baseline values. The levels of MMP-9 (p = 0.024) and MMP-2 (p < 0.01) were significantly increased compared to baseline values. CONCLUSION In addition to the effective blood pressure reduction in response to RSD, this study demonstrates a positive effect of RSD on biomarkers reflecting vascular inflammation and remodeling. These results suggest a possible prognostic benefit of RSD in high-risk patients for endothelial dysfunction and cardiovascular remodeling as well as end-organ damage.
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Affiliation(s)
- Oliver Dörr
- Department of Cardiology, University of Giessen, Klinikstr. 33, 35392, Giessen, Germany,
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14
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Cubbon RM, Woolston A, Adams B, Gale CP, Gilthorpe MS, Baxter PD, Kearney LC, Mercer B, Rajwani A, Batin PD, Kahn M, Sapsford RJ, Witte KK, Kearney MT. Prospective development and validation of a model to predict heart failure hospitalisation. Heart 2014; 100:923-9. [PMID: 24647052 PMCID: PMC4033182 DOI: 10.1136/heartjnl-2013-305294] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Objective Acute heart failure syndrome (AHFS) is a major cause of hospitalisation and imparts a substantial burden on patients and healthcare systems. Tools to define risk of AHFS hospitalisation are lacking. Methods A prospective cohort study (n=628) of patients with stable chronic heart failure (CHF) secondary to left ventricular systolic dysfunction was used to derive an AHFS prediction model which was then assessed in a prospectively recruited validation cohort (n=462). Results Within the derivation cohort, 44 (7%) patients were hospitalised as a result of AHFS during 1 year of follow-up. Predictors of AHFS hospitalisation included furosemide equivalent dose, the presence of type 2 diabetes mellitus, AHFS hospitalisation within the previous year and pulmonary congestion on chest radiograph, all assessed at baseline. A multivariable model containing these four variables exhibited good calibration (Hosmer–Lemeshow p=0.38) and discrimination (C-statistic 0.77; 95% CI 0.71 to 0.84). Using a 2.5% risk cut-off for predicted AHFS, the model defined 38.5% of patients as low risk, with negative predictive value of 99.1%; this low risk cohort exhibited <1% excess all-cause mortality per annum when compared with contemporaneous actuarial data. Within the validation cohort, an identically applied model derived comparable performance parameters (C-statistic 0.81 (95% CI 0.74 to 0.87), Hosmer–Lemeshow p=0.15, negative predictive value 100%). Conclusions A prospectively derived and validated model using simply obtained clinical data can identify patients with CHF at low risk of hospitalisation due to AHFS in the year following assessment. This may guide the design of future strategies allocating resources to the management of CHF.
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Affiliation(s)
- R M Cubbon
- Leeds Multidisciplinary Cardiovascular Research Centre, University of Leeds, Leeds, UK
| | - A Woolston
- Centre of Epidemiology and Biostatistics, University of Leeds, Leeds, UK
| | - B Adams
- Leeds Multidisciplinary Cardiovascular Research Centre, University of Leeds, Leeds, UK
| | - C P Gale
- Leeds Multidisciplinary Cardiovascular Research Centre, University of Leeds, Leeds, UK Centre of Epidemiology and Biostatistics, University of Leeds, Leeds, UK
| | - M S Gilthorpe
- Centre of Epidemiology and Biostatistics, University of Leeds, Leeds, UK
| | - P D Baxter
- Centre of Epidemiology and Biostatistics, University of Leeds, Leeds, UK
| | - L C Kearney
- Leeds Multidisciplinary Cardiovascular Research Centre, University of Leeds, Leeds, UK
| | - B Mercer
- Leeds Multidisciplinary Cardiovascular Research Centre, University of Leeds, Leeds, UK
| | - A Rajwani
- Leeds Multidisciplinary Cardiovascular Research Centre, University of Leeds, Leeds, UK
| | - P D Batin
- Mid Yorkshire Hospitals NHS Trust, Wakefield, UK
| | - M Kahn
- Leeds Multidisciplinary Cardiovascular Research Centre, University of Leeds, Leeds, UK
| | | | - K K Witte
- Leeds Multidisciplinary Cardiovascular Research Centre, University of Leeds, Leeds, UK
| | - M T Kearney
- Leeds Multidisciplinary Cardiovascular Research Centre, University of Leeds, Leeds, UK
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15
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Lopez-Andrès N, Rossignol P, Iraqi W, Fay R, Nuée J, Ghio S, Cleland JG, Zannad F, Lacolley P. Association of galectin-3 and fibrosis markers with long-term cardiovascular outcomes in patients with heart failure, left ventricular dysfunction, and dyssynchrony: insights from the CARE-HF (Cardiac Resynchronization in Heart Failure) trial. Eur J Heart Fail 2014; 14:74-81. [DOI: 10.1093/eurjhf/hfr151] [Citation(s) in RCA: 172] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Natalia Lopez-Andrès
- Inserm U961; Nancy Université; Nancy France
- Inserm; Centre d'Investigation Clinique de Nancy CIC-P 9501; Vandoeuvre-les-Nancy France
| | - Patrick Rossignol
- Inserm U961; Nancy Université; Nancy France
- Inserm; Centre d'Investigation Clinique de Nancy CIC-P 9501; Vandoeuvre-les-Nancy France
- CHU de Nancy, Department of Cardiology, Heart Failure and Hypertension Unit; Institut Lorrain du Cœur et des Vaisseaux Louis Mathieu; Vandoeuvre-Lès Nancy France
- Nancy-Université, Faculté de Médecine; Vandoeuvre-lès-Nancy France
| | - Wafae Iraqi
- Inserm U961; Nancy Université; Nancy France
- Inserm; Centre d'Investigation Clinique de Nancy CIC-P 9501; Vandoeuvre-les-Nancy France
- CHU de Nancy, Department of Cardiology, Heart Failure and Hypertension Unit; Institut Lorrain du Cœur et des Vaisseaux Louis Mathieu; Vandoeuvre-Lès Nancy France
- Nancy-Université, Faculté de Médecine; Vandoeuvre-lès-Nancy France
| | - Renaud Fay
- Inserm; Centre d'Investigation Clinique de Nancy CIC-P 9501; Vandoeuvre-les-Nancy France
- CHU de Nancy, Department of Cardiology, Heart Failure and Hypertension Unit; Institut Lorrain du Cœur et des Vaisseaux Louis Mathieu; Vandoeuvre-Lès Nancy France
- Nancy-Université, Faculté de Médecine; Vandoeuvre-lès-Nancy France
| | - Josette Nuée
- Inserm U961; Nancy Université; Nancy France
- Inserm; Centre d'Investigation Clinique de Nancy CIC-P 9501; Vandoeuvre-les-Nancy France
- CHU de Nancy, Department of Cardiology, Heart Failure and Hypertension Unit; Institut Lorrain du Cœur et des Vaisseaux Louis Mathieu; Vandoeuvre-Lès Nancy France
- Nancy-Université, Faculté de Médecine; Vandoeuvre-lès-Nancy France
| | - Stefano Ghio
- Division of Cardiology; Fondazione IRCCS Policlinico S Matteo, University Hospital; Piazzale Golgi 1 Pavia Italy
| | | | - Faiez Zannad
- Inserm U961; Nancy Université; Nancy France
- Inserm; Centre d'Investigation Clinique de Nancy CIC-P 9501; Vandoeuvre-les-Nancy France
- CHU de Nancy, Department of Cardiology, Heart Failure and Hypertension Unit; Institut Lorrain du Cœur et des Vaisseaux Louis Mathieu; Vandoeuvre-Lès Nancy France
- Nancy-Université, Faculté de Médecine; Vandoeuvre-lès-Nancy France
| | - Patrick Lacolley
- Inserm U961; Nancy Université; Nancy France
- Inserm; Centre d'Investigation Clinique de Nancy CIC-P 9501; Vandoeuvre-les-Nancy France
- CHU de Nancy, Department of Cardiology, Heart Failure and Hypertension Unit; Institut Lorrain du Cœur et des Vaisseaux Louis Mathieu; Vandoeuvre-Lès Nancy France
- Nancy-Université, Faculté de Médecine; Vandoeuvre-lès-Nancy France
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16
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Dorsch MP, Nemerovski CW, Ellingrod VL, Cowger JA, Dyke DB, Koelling TM, Wu AH, Aaronson KD, Simpson RU, Bleske BE. Vitamin D receptor genetics on extracellular matrix biomarkers and hemodynamics in systolic heart failure. J Cardiovasc Pharmacol Ther 2014; 19:439-45. [PMID: 24500905 DOI: 10.1177/1074248413517747] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Vitamin D deficiency has been associated with the development of myocardial hypertrophy and inflammation. These findings suggest that vitamin D status and vitamin D receptor (VDR) genomics may play a role in myocardial fibrosis. The aim of this pilot study was to determine the association between vitamin D levels, VDR polymorphisms, and biomarkers of left ventricular remodeling and hemodynamics. METHODS In a cross-sectional pilot study, patients with ejection fraction (EF) <40% (and New York Heart Association ≥ II) undergoing right heart catheterization were included in the study. Blood was collected for determination of 25-hydroxyvitamin D level (antibody competitive immunoassay), VDR genotypes (BsmI, ApaI, TaqI, and FokI), and biomarkers (N-terminal propeptide of collagen type III [PIIINP], matrix metalloproteinase 2, and galectin 3). The vitamin D genotypes were determined through the use of pyrosequencing. RESULTS A total of 30 patients with a mean EF of 17% ± 8% were enrolled. There was a significant association between the BsmI C allele, ApaI G allele, and TaqI A allele, which formed a haplotype block (CGA) for analysis. There were no differences in baseline parameters between patients with the VDR haplotype block (n = 20) and those without (n = 10). Individual genotypes were not associated with any biomarker or hemodynamics. Patients with the CGA haplotype demonstrated significantly higher log PIIINP values (1.74 ± 0.32 mcg/mL vs 1.36 ± 0.31 mcg/mL, P = .0041). When evaluating vitamin D levels below and above the median level (19 ng/mL), there was no significant difference between these 2 groups in regard to biomarker levels for left ventricular remodeling. CONCLUSION This study has shown that a biomarker for collagen type III synthesis, PIIINP, was associated with the CGA haplotype of BsmI, ApaI, and TaqI single nucleotide polymorphisms on the VDR. These findings suggest that VDR genetics may play a role in myocardial fibrosis in patients with systolic heart failure.
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Affiliation(s)
- Michael P Dorsch
- Department of Pharmacy Services, University of Michigan Health System, Ann Arbor, Michigan, USA
| | | | - Vicki L Ellingrod
- Department of Clinical and Social Administrative Sciences, University of Michigan, College of Pharmacy, Ann Arbor, MI, USA
| | | | - D Bradley Dyke
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan Health Systems, Ann Arbor, MI, USA
| | - Todd M Koelling
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan Health Systems, Ann Arbor, MI, USA
| | - Audrey H Wu
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan Health Systems, Ann Arbor, MI, USA
| | - Keith D Aaronson
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan Health Systems, Ann Arbor, MI, USA
| | - Robert U Simpson
- Department of Pharmacology, University of Michigan, Medical School, Ann Arbor, MI, USA
| | - Barry E Bleske
- Department of Clinical and Social Administrative Sciences, University of Michigan, College of Pharmacy, Ann Arbor, MI, USA
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17
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Chang YY, Chen A, Wu XM, Hsu TP, Liu LYD, Chen YH, Wu YW, Lin HJ, Hsu RB, Lee CM, Wang SS, Lo MT, Chen MF, Lin YH. Comparison the prognostic value of galectin-3 and serum markers of cardiac extracellular matrix turnover in patients with chronic systolic heart failure. Int J Med Sci 2014; 11:1098-106. [PMID: 25170292 PMCID: PMC4147635 DOI: 10.7150/ijms.8083] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 07/31/2014] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Galectin-3 (Gal-3) shows the ability of survival prediction in heart failure (HF) patients. However, Gal-3 is strongly associated with serum markers of cardiac extracellular matrix (ECM) turnover. The aim of this study is to compare the impact of Gal-3 and serum markers of cardiac ECM turnover on prognostic prediction of chronic systolic HF patients. METHODS Serum Gal-3, brain natriuretic peptide (BNP), extracellular matrix including type I and III aminoterminal propeptide of procollagen (PINP and PIIINP), matrix metalloproteinase-2, 9 (MMP-2, 9), and tissue inhibitor of metalloproteinase-1 (TIMP-1) were analyzed. Cox regression analysis was used for survival analysis. RESULTS A total of 105 (81 male) patients were enrolled. During 980±346 days follow-up, 17 patients died and 36 episodes of HF admission happened. Mortality of these patients was significantly associated with the log PIIINP (β= 15.380; P=0.042), log TIMP-1(β= 44.530; P=0.003), log MMP-2 (β= 554.336; P<0.001), log BNP (β= 28.273; P=0.034). Log Gal-3 (β= 7.484; P=0.066) is borderline associated with mortality. Mortality or first HF admission of these patients was significantly associated with the log TIMP-1(β= 16.496; P=0.006), log MMP-2 (β= 221.864; P<0.001), log BNP (β= 5.999; P=0.034). Log Gal-3 (β= 4.486; P=0.095) only showed borderline significance. In several models adjusting clinical parameters, log MMP-2 was significantly associated with clinical outcome. In contrast, log Gal-3 was not. CONCLUSION The prognostic strength of MMP-2 to clinical outcome prediction in HF patients is stronger than Gal-3.
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Affiliation(s)
- Yi-Yao Chang
- 1. Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Aaron Chen
- 2. Woodhull Medical and Mental Hospital, Brooklyn, New York, USA
| | - Xue-Ming Wu
- 3. Department of Internal Medicine, Taoyuan General Hospital, Taoyuan, Taiwan
| | - Tse-Pin Hsu
- 4. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Li-Yu Daisy Liu
- 6. Department of Agronomy, Biometry Division, National Taiwan University, Taipei, Taiwan
| | - Yenh-Hsein Chen
- 4. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yen-Wen Wu
- 1. Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan; ; 7. National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Hung-Ju Lin
- 4. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ron-Bin Hsu
- 5. Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chi-Ming Lee
- 4. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Shoei-Shen Wang
- 5. Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Men-Tzung Lo
- 8. Center for Dynamical Biomarkers and Translational Medicine, National Central University, Chungli, Taiwan
| | - Ming-Fong Chen
- 4. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yen-Hung Lin
- 4. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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19
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Jacquier A, Kallifatidis A, Guibert N, Giorgi R, Falque C, Thuny F, Croisille P, Clarysse P, Maurel B, Flavian A, Gaubert JY, Moulin G, Habib G. Assessment of myocardial partition coefficient of gadolinium (λ) in dilated cardiomyopathy and its impact on segmental and global systolic function. J Magn Reson Imaging 2013; 40:1336-41. [DOI: 10.1002/jmri.24515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 10/03/2013] [Indexed: 11/11/2022] Open
Affiliation(s)
- Alexis Jacquier
- Department of Radiology; Aix Marseille Université, Hôpital Universitaire la Timone; Marseille France
- Centre de Résonance Magnétique Biologique et Médicale (CRMBM); UMR CNRS n° 6612, Aix Marseille Université, Faculté de Médecine de Marseille Marseille France
| | - Alexandros Kallifatidis
- Department of Radiology; Aix Marseille Université, Hôpital Universitaire la Timone; Marseille France
| | - Nicolas Guibert
- APHM, hôpital Timone, Service de Santé Publique et d'Information Médicale; Marseille France
| | - Roch Giorgi
- APHM, hôpital Timone, Service de Santé Publique et d'Information Médicale; Marseille France
- Department of Cardiology; Aix Marseille Université, Hôpital Universitaire la Timone; Marseille France
- INSERM; UMR_S 912 (SESSTIM) Marseille France
| | - Claire Falque
- Department of Radiology; Aix Marseille Université, Hôpital Universitaire la Timone; Marseille France
| | - Franck Thuny
- Department of Cardiology; Aix Marseille Université, Hôpital Universitaire la Timone; Marseille France
| | - Pierre Croisille
- CREATIS; Université de Lyon; CNRS UMR 5220, Inserm U630; INSA Lyon, Hospice civils de Lyon France
| | - Patrick Clarysse
- CREATIS; Université de Lyon; CNRS UMR 5220, Inserm U630; INSA Lyon, Hospice civils de Lyon France
| | - Boris Maurel
- Department of Radiology; Aix Marseille Université, Hôpital Universitaire la Timone; Marseille France
| | - Antonin Flavian
- Department of Radiology; Aix Marseille Université, Hôpital Universitaire la Timone; Marseille France
| | - Jean-Yves Gaubert
- Department of Radiology; Aix Marseille Université, Hôpital Universitaire la Timone; Marseille France
| | - Guy Moulin
- Department of Radiology; Aix Marseille Université, Hôpital Universitaire la Timone; Marseille France
| | - Gilbert Habib
- Department of Cardiology; Aix Marseille Université, Hôpital Universitaire la Timone; Marseille France
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20
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Marti CN, Fonarow GC, Gheorghiade M, Butler J. Timing and duration of interventions in clinical trials for patients with hospitalized heart failure. Circ Heart Fail 2013; 6:1095-101. [PMID: 24046476 DOI: 10.1161/circheartfailure.113.000518] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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21
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Felker GM, Fiuzat M, Thompson V, Shaw LK, Neely ML, Adams KF, Whellan DJ, Donahue MP, Ahmad T, Kitzman DW, Piña IL, Zannad F, Kraus WE, O'Connor CM. Soluble ST2 in ambulatory patients with heart failure: Association with functional capacity and long-term outcomes. Circ Heart Fail 2013; 6:1172-9. [PMID: 24103327 DOI: 10.1161/circheartfailure.113.000207] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND ST2 is involved in cardioprotective signaling in the myocardium and has been identified as a potentially promising biomarker in heart failure (HF). We evaluated ST2 levels and their association with functional capacity and long-term clinical outcomes in a cohort of ambulatory patients with HF enrolled in the Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION) study-a multicenter, randomized study of exercise training in HF. METHODS AND RESULTS HF-ACTION randomized 2331 patients with left ventricular ejection fraction <0.35 and New York Heart Association class II to IV HF to either exercise training or usual care. ST2 was analyzed in a subset of 910 patients with evaluable plasma samples. Correlations and Cox models were used to assess the relationship among ST2, functional capacity, and long-term outcomes. The median baseline ST2 level was 23.7 ng/mL (interquartile range, 18.6-31.8). ST2 was modestly associated with measures of functional capacity. In univariable analysis, ST2 was significantly associated with death or hospitalization (hazard ratio, 1.48; P<0.0001), cardiovascular death or HF hospitalization (hazard ratio, 2.14; P<0.0001), and all-cause mortality (hazard ratio, 2.33; P<0.0001; all hazard ratios for log2 ng/mL). In multivariable models, ST2 remained independently associated with outcomes after adjustment for clinical variables and amino-terminal pro-B-type natriuretic peptide. However, ST2 did not add significantly to reclassification of risk as assessed by changes in the C statistic, net reclassification improvement, and integrated discrimination improvement. CONCLUSIONS ST2 was modestly associated with functional capacity and was significantly associated with outcomes in a well-treated cohort of ambulatory patients with HF although it did not significantly affect reclassification of risk. CLINICAL TRIAL INFORMATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00047437.
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Affiliation(s)
- G Michael Felker
- Division of Cardiology, Duke University Medical Center, Durham, NC
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22
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Abstract
In contrast to public perception, the morbidity and mortality and the resultant healthcare costs associated with chronic heart failure (HF) are increasing and arguably reaching epidemic proportions. Although basic research efforts have provided unique insights into fundamental processes that govern myocardial extracellular matrix (ECM) growth and function, the translation of these findings to improved diagnostics and therapeutics for HF has not been as forthcoming. The factors that contribute to this relative paucity of new clinical tools for HF are multifactorial but likely include the need to recognize and differentiate HF phenotypes and to couple the use of biomarkers and multimodality imaging in early translational research studies. Recognizing the classification scheme of HF with a reduced ejection fraction (EF) to that of HF with a preserved EF and incorporating unique and differential measurements of ECM remodeling to these specific disease processes are warranted. For example, profiling pathways of ECM degradation such as the matrix metalloproteinases in patients with ischemic heart disease and HF with a reduced EF can provide prognostic information in terms of risk of progression to HF. In patients with chronic hypertensive disease and HF with a preserved EF, plasma profiling indexes of ECM synthesis and turnover, as well as advances in ECM imaging, have been shown to provide diagnostic and prognostic use. In terms of therapeutics, strategies to stabilize the ECM in HF with a reduced EF hold potential, whereas in contradistinction, selective antifibrotic agents may hold promise for HF with a preserved EF.
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Affiliation(s)
- Francis G Spinale
- Cardiovascular Translational Research Center, University of South Carolina School of Medicine, Columbia, SC 29209, USA.
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Rehn TA, Munkvik M, Lunde PK, Sjaastad I, Sejersted OM. Intrinsic skeletal muscle alterations in chronic heart failure patients: a disease-specific myopathy or a result of deconditioning? Heart Fail Rev 2013; 17:421-36. [PMID: 21996779 DOI: 10.1007/s10741-011-9289-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Chronic heart failure (CHF) patients frequently experience impaired exercise tolerance due to skeletal muscle fatigue. Studies suggest that this in part is due to intrinsic alterations in skeletal muscle of CHF patients, often interpreted as a disease-specific myopathy. Knowledge about the mechanisms underlying these skeletal muscle alterations is of importance for the pathophysiological understanding of CHF, therapeutic approach and rehabilitation strategies. We here critically review the evidence for skeletal muscle alterations in CHF, the underlying mechanisms of such alterations and how skeletal muscle responds to training in this patient group. Skeletal muscle characteristics in CHF patients are very similar to what is reported in response to chronic obstructive pulmonary disease (COPD), detraining and deconditioning. Furthermore, skeletal muscle alterations observed in CHF patients are reversible by training, and skeletal muscle of CHF patients seems to be at least as trainable as that of matched controls. We argue that deconditioning is a major contributor to the skeletal muscle dysfunction in CHF patients and that further research is needed to determine whether, and to what extent, the intrinsic skeletal muscle alterations in CHF represent an integral part of the pathophysiology in this disease.
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Affiliation(s)
- T A Rehn
- Institute for Experimental Medical Research, Oslo University Hospital, Ullevaal, Oslo, Norway.
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Lai CTM, Chow PC, Wong SJ, Chan KW, Cheung YF. Circulating annexin A5 levels after atrial switch for transposition of the great arteries: relationship with ventricular deformation and geometry. PLoS One 2012; 7:e52125. [PMID: 23284897 PMCID: PMC3527428 DOI: 10.1371/journal.pone.0052125] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 11/09/2012] [Indexed: 01/01/2023] Open
Abstract
Background Inflammatory cytokines, cardiomyocyte apoptosis, and altered collagen turnover may contribute to unfavourable ventricular remodeling. This unfavourable ventricular remodelling is well documented in patients after atrial switch operation for complete transposition of the great arteries. We therefore tested if levels of circulating markers of inflammation, apoptosis, collagen synthesis, and extracellular matrix degradation are altered in patients after atrial switch operation for transposition of the great arteries. Methods and Results Circulating tumour necrosis factor (TNF)-α, annexin A5 (AnxA5), carboxy-terminal propeptide of type I procollagen (PICP), amino-terminal propeptide of type III procollagen (PIIINP), matrix metalloproteinase-1 (MMP-1), and tissue inhibitor of metalloproteinase-1 (TIMP-1) levels were determined in 27 patients aged 25.2±3.1 years and 20 controls. Ventricular myocardial deformation and left ventricular eccentricity index (EI) were determined by speckle tracking and two-dimensional echocardiography, respectively. Compared with controls, patients had significantly higher circulating AnxA5 (p<0.001) and TNF-α (p = 0.018) levels, but similar PICP, PIIINP, MMP-1 and TIMP-1 levels. For the whole cohort, plasma AnxA5 correlated with serum TNF-α (p = 0.002), systemic ventricular global longitudinal strain (GLS) and systolic and early diastolic strain rate (all p<0.001), and subpulmonary ventricular GLS and early diastolic strain rate (both p<0.001). In patients, plasma AnxA5 level correlated positively with subpulmonary ventricular EI (p = 0.027). Multiple linear regression analysis identified systemic ventricular GLS (β = −0.50, p<0.001) and serum TNF-α (β = 0.29, p = 0.022) as significant correlates of plasma AnxA5. Conclusions Elevated plasma AnxA5 level in patients after atrial switch operation is associated with impaired systemic myocardial deformation, increased subpulmonary ventricular eccentricity, and increased serum TNF-α level.
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Affiliation(s)
- Clare T. M. Lai
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Pak-cheong Chow
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Sophia J. Wong
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Koon-wing Chan
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Yiu-fai Cheung
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
- * E-mail:
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Kalogeropoulos AP, Georgiopoulou VV, Butler J. Clinical adoption of prognostic biomarkers: the case for heart failure. Prog Cardiovasc Dis 2012; 55:3-13. [PMID: 22824105 DOI: 10.1016/j.pcad.2012.05.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The recent explosion of scientific knowledge and technological progress has led to the discovery of a large array of circulating molecules commonly referred to as biomarkers. Biomarkers in heart failure (HF) research have been used to provide pathophysiologic insights, aid in establishing the diagnosis, refine prognosis, guide management, and target treatment. However, beyond diagnostic applications of natriuretic peptides, there are currently few widely recognized applications for biomarkers in HF. This represents a remarkable discordance considering the number of molecules that have been shown to correlate with outcomes, refine risk prediction, or track disease severity in HF in the past decade. In this article, we use a broad framework proposed for cardiovascular risk markers to summarize the current state of biomarker development for patients with HF. We use this framework to identify the challenges of biomarker adoption for risk prediction, disease management, and treatment selection for HF and suggest considerations for future research.
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Iyer RP, Patterson NL, Fields GB, Lindsey ML. The history of matrix metalloproteinases: milestones, myths, and misperceptions. Am J Physiol Heart Circ Physiol 2012; 303:H919-30. [PMID: 22904159 DOI: 10.1152/ajpheart.00577.2012] [Citation(s) in RCA: 116] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Since the discovery of tadpole collagenase in 1962, the matrix metalloproteinase (MMP) family has emerged as a significant proteinase group with recognized effects on the cardiovascular system. Over the last 40 years, many milestones have been achieved, from the identification of the first MMP, to the generation of the first MMP cDNA clone and null mouse, to the clinical approval of the first MMP inhibitor. Over the years, a few myths and misunderstandings have interwoven into the truths. In this review, we will discuss the major milestones of MMP research, as well as review the misinterpretations and misperceptions that have evolved. Clarifying the confusions and dispelling the myths will both provide a better understanding of MMP properties and functions and focus the cardiovascular field on the outstanding research questions that need to be addressed.
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Affiliation(s)
- Rugmani Padmanabhan Iyer
- San Antonio Cardiovascular Proteomics Center, The University of Texas Health Science Center at San Antonio, San Antonio, Texas 78245, USA
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Agrinier N, Thilly N, Boivin JM, Dousset B, Alla F, Zannad F. Prognostic value of serum PIIINP, MMP1 and TIMP1 levels in hypertensive patients: a community-based prospective cohort study. Fundam Clin Pharmacol 2012; 27:572-80. [DOI: 10.1111/j.1472-8206.2012.01053.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Revised: 05/04/2012] [Accepted: 06/01/2012] [Indexed: 01/03/2023]
Affiliation(s)
| | | | - Jean-Marc Boivin
- Departement of Cardiology; INSERM; CIC9501 and U961, CHU Nancy; Hypertension and Heart Failure Unit; CHU, Université de Lorraine; 54500; Vandœuvre les Nancy; France
| | | | | | - Faiez Zannad
- Departement of Cardiology; INSERM; CIC9501 and U961, CHU Nancy; Hypertension and Heart Failure Unit; CHU, Université de Lorraine; 54500; Vandœuvre les Nancy; France
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Latini R, Gullestad L, Masson S, Nymo SH, Ueland T, Cuccovillo I, Vårdal M, Bottazzi B, Mantovani A, Lucci D, Masuda N, Sudo Y, Wikstrand J, Tognoni G, Aukrust P, Tavazzi L. Pentraxin-3 in chronic heart failure: the CORONA and GISSI-HF trials. Eur J Heart Fail 2012; 14:992-9. [PMID: 22740508 DOI: 10.1093/eurjhf/hfs092] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
AIMS Pentraxin-3 (PTX3) is a component of the humoral arm of innate immunity which can regulate inflammatory processes. Since the role of inflammation in the progression of chronic heart failure (HF) is debated, we investigated the prognostic value of PTX3 and the effect of a statin in two large populations of patients with HF. METHODS AND RESULTS Plasma levels of PTX3 were measured at randomization and after 3 months in 1457 patients enrolled in the Controlled Rosuvastatin Multinational Trial in HF (CORONA) and 1233 patients enrolled in the GISSI-Heart Failure trial (GISSI-HF). The relationships between baseline PTX3 levels or their changes over time and mortality were evaluated with multivariable Cox proportional hazard models including clinical factors, high sensitivity C-reactive protein (hsCRP), and N-terminal pro brain natriuretic peptide (NT-proBNP). PTX3 concentration [median (Q1-Q3) = 5.34 (3.55-7.64) ng/mL, n = 2690] was higher in females, in older patients, and those with lower body mass index. Baseline elevated PTX3 was associated with a higher risk of all-cause mortality [759 events, hazard ratio (HR) for 1 SD increase 1.20, 95% confidence interval (CI) 1.12-1.30, P < 0.0001], cardiovascular mortality (587 events, HR 1.27, 95% CI 1.17-1.38, P < 0.0001), or hospitalization for worsening HF (720 events, HR 1.21, 95% CI 1.12-1.30, P < 0.0001), and marginally improved discrimination. Three-month changes in PTX3 were associated with fatal events after adjustment for hsCRP or NT-proBNP. Rosuvastatin lowered hsCRP levels but significantly raised PTX3. CONCLUSION In two independent clinical trials that enrolled patients with chronic HF, PTX3 was consistently associated with outcomes. The opposite effects of a statin on hsCRP and PTX3 call for further investigation. TRIAL REGISTRATION NCT00336336 (GISSI-HF), NCT00206310 (CORONA).
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Affiliation(s)
- Roberto Latini
- Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche Mario Negri, via Giuseppe La Masa 19, 20156 Milan, Italy.
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Cao W, Guo XW, Zheng HZ, Li DP, Jia GB, Wang J. Current progress of research on pharmacologic actions of salvianolic acid B. Chin J Integr Med 2012; 18:316-20. [PMID: 22457144 DOI: 10.1007/s11655-012-1052-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Indexed: 01/30/2023]
Abstract
As one of the main water-soluble composites of Radix Salviae, salvianolic acid B is a phenolic acid ingredient of the Chinese drug, which is rich content in the herb and has strong pharmaceutical activity. It is used to treat cardiocerebral vascular diseases, antagonize hepatic/renal fibrosis, prevent cancer, and promote stem cell proliferation and differentiation. In the researches of its acting mechanisms, rather deepened studies have been carried out for its application on cardiocerebral vascular diseases, but that for others are rather fewer.
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Affiliation(s)
- Wei Cao
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Long-Term Statin Therapy in Patients With Systolic Heart Failure and Normal Cholesterol: Effects on Elevated Serum Markers of Collagen Turnover, Inflammation, and B-Type Natriuretic Peptide. Clin Ther 2012; 34:91-100. [DOI: 10.1016/j.clinthera.2011.11.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Revised: 11/01/2011] [Accepted: 11/01/2011] [Indexed: 11/23/2022]
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de Denus S, Lavoie J, Ducharme A, O'Meara E, Racine N, Sirois MG, Neagoe PE, Zhu L, Rouleau JL, White M. Differences in biomarkers in patients with heart failure with a reduced vs a preserved left ventricular ejection fraction. Can J Cardiol 2011; 28:62-8. [PMID: 22104539 DOI: 10.1016/j.cjca.2011.09.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2010] [Revised: 09/01/2011] [Accepted: 09/01/2011] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The differences in concentrations of biomarkers between heart failure (HF) patients with a preserved left ventricular ejection fraction (LVEF), or HF-PEF, and patients with HF with reduced LVEF (HF-REF) have yet to be defined. The objectives of this study were to compare the concentrations and correlation of biomarkers of inflammation, extracellular matrix (ECM) turnover and neurohormonal activation between these populations. METHODS We performed a cross-sectional study of 29 subjects with symptomatic HF-REF (LVEF = 25.6 ± 5.1%) and 29 subjects with symptomatic HF-PEF (LVEF = 63.3 ± 5.3%). Concentrations of N-terminal proB-type natriuretic peptide (NT-proBNP), high sensitivity C-reactive protein (hsCRP), procollagen type III amino-terminal peptide (PIIINP), matrix metalloproteinase (MMP)-2, MMP-9, and tissue inhibitor of MMP (TIMP)-1 were measured. RESULTS Although NT-proBNP and PIIINP concentrations were higher in patients with HF-REF compared with patients with HF-PEF (both P < 0.05), the only significant difference between the groups remaining after adjusting for possible confounding variables was NT-proBNP (P = 0.02). In patients with HF-REF, NT-proBNP correlated with PIIINP (P < 0.05), TIMP-1 (P < 0.05), and MMP-2 (P = 0.002), while PIIINP correlated with TIMP-1 (P < 0.05) and MMP-2 (P < 0.0001). In patients with a HF-PEF, only high sensitivity C-reactive protein correlated significantly with MMP-2 (P = 0.002). CONCLUSIONS Patients with HF-REF or HF-PEF presenting similar symptoms and functional limitations exhibit similar concentrations of biomarkers of ECM and inflammation. However, patients with HF-REF exhibit significantly higher NT-proBNP concentrations than patients with HF-PEF. The differences in the correlations observed between the biomarkers between these 2 populations suggest some heterogeneity and differences in the mechanisms related to the release or clearance of biomarkers in HF-REF vs HF-PEF.
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Affiliation(s)
- Simon de Denus
- Research Center, Montreal Heart Institute and Université de Montréal, Montréal, Québec, Canada
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Harutyunyan M, Christiansen M, Johansen JS, Køber L, Torp-Petersen C, Kastrup J. The inflammatory biomarker YKL-40 as a new prognostic marker for all-cause mortality in patients with heart failure. Immunobiology 2011; 217:652-6. [PMID: 22209156 DOI: 10.1016/j.imbio.2011.11.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Accepted: 11/12/2011] [Indexed: 10/15/2022]
Abstract
BACKGROUND Despite progress in management of patients with heart failure (HF) these patients still have a poor prognosis. We tested the hypothesis whether the inflammatory biomarker YKL-40 alone or in combination with high-sensitivity C-reactive protein (hs-CRP) and/or N-terminal-pro-B natriuretic peptide (NT-proBNP) could be a new prognostic biomarker for all-cause mortality in patients with HF. METHODS AND RESULTS A total of 717 of the 1000 patients with severe left ventricular systolic dysfunction included in the EchoCardiography and Heart Outcome Study were included in Denmark and had blood sample available for serum YKL-40 determination. Mean age of patients was 70 years, and 73% were male. During the 7 years follow-up period 458 patients died. Patients were categorised according to serum YKL-40 at entry into four quartiles: quartile I with median serum YKL-40=60 μg/L (5-95% Confidence interval (CI): 30-82), quartile II: YKL-40=107 μg/L (CI: 86-132), quartile III: YKL-40=169 μg/L (CI: 142-221), and quartile IV: YKL-40=286 μg/L (CI: 230-770). Hazard ratios for all-cause mortality were with quartile I as reference 1.33 (CI: 0.99-1.80), 1.35 (CI: 0.99-1.82), and 1.54 (CI: 1.14-2.08) for serum YKL-40 II to IV quartiles, respectively following multivariable adjustment for cardiovascular risk factors (age, left ventricular ejection fraction, gender, history of heart failure, ischemic heart disease, chronic pulmonary disease, diabetes mellitus, stroke, hypertension, NT-proBNP, hs-CRP, and renal function). CONCLUSION Serum YKL-40 is significantly associated with all-cause mortality in patients with HF and could potentially be a new prognostic biomarker in these patients.
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Affiliation(s)
- Marina Harutyunyan
- Department of Medicine B, The Heart Centre, Rigshospitalet, Copenhagen University Hospital and Faculty of Health Sciences, Denmark
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Plasma metalloproteinase levels and left ventricular remodeling in hypertrophic cardiomyopathy in patients with an identical mutation. J Cardiol 2011; 58:261-5. [DOI: 10.1016/j.jjcc.2011.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2011] [Revised: 07/16/2011] [Accepted: 07/24/2011] [Indexed: 12/17/2022]
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Lai CT, Chan KW, Wong SJ, Chow PC, Cheung YF. Circulating levels of biomarkers of collagen synthesis and ventricular function and dyssynchrony in adolescents and young adults after repair of tetralogy of Fallot. Am Heart J 2011; 162:467-73. [PMID: 21884862 DOI: 10.1016/j.ahj.2011.05.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Accepted: 05/23/2011] [Indexed: 01/19/2023]
Abstract
BACKGROUND Circulating carboxy-terminal propeptide of type I procollagen (PICP) and amino-terminal propeptide of type III procollagen (PIIINP) are biomarkers of collagen synthesis. We tested the hypothesis that circulating PICP and PIIINP are altered and may correlate with ventricular volume load and function in patients with repaired tetralogy of Fallot (TOF). METHODS AND RESULTS Serum PICP and plasma PIIINP levels were determined in 39 patients with repaired TOF aged 17.7 ± 4.1 years and 25 healthy controls and correlated with right ventricular (RV) and left ventricular (LV) volumes, functional indices, and mechanical dyssynchrony as assessed by 3-dimensional and tissue Doppler echocardiography. Compared with controls, patients had significantly higher circulating PICP (P = .016) and PIIINP (P = .008) levels, worse RV function with intra-RV mechanical delay (all P < .001), impaired LV systolic functional indices (all P < .05), and greater LV systolic dyssynchrony index (SDI) (P < .001). For the whole cohort, circulating PICP and PIIINP levels correlated with age (P = .001 and P < .001, respectively), body mass index (P = .033 and P = .012, respectively), LV eccentricity (P = .035 and P = .046, respectively), RV end-diastolic volume (P = .029 and P = .047, respectively), and LV SDI (both P < .001). In addition, PICP levels correlated negatively with RV and LV isovolumic acceleration and RV ejection fraction. Multiple linear regression analysis identified LV SDI as a significant independent correlate of circulating levels of PICP (β = .31, P = .045) and PIIINP (β = .37, P = .004). CONCLUSION Circulating levels of PICP and PIIINP correlate positively with LV mechanical dyssynchrony in patients after TOF repair, implicating a possible role of increased collagen synthesis in its pathogenesis.
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Bhalla V, Georgiopoulou VV, Azeem AA, Marti CN, Cole RT, Laskar SR, De Staercke C, Hooper WC, Smith AL, Kalogeropoulos AP, Butler J. Matrix metalloproteinases, tissue inhibitors of metalloproteinases, and heart failure outcomes. Int J Cardiol 2011; 151:237-9. [PMID: 21723628 DOI: 10.1016/j.ijcard.2011.06.048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Accepted: 06/06/2011] [Indexed: 11/27/2022]
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Miyasato SK, Loeffler J, Shohet R, Zhang J, Lindsey M, Le Saux CJ. Caveolin-1 modulates TGF-β1 signaling in cardiac remodeling. Matrix Biol 2011; 30:318-29. [PMID: 21641995 DOI: 10.1016/j.matbio.2011.05.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Revised: 04/27/2011] [Accepted: 05/20/2011] [Indexed: 02/06/2023]
Abstract
The cardiac response to myocardial injury includes fibrotic and hypertrophic processes and a key mediator in this response is transforming growth factor-β1 (TGF-β1). Caveolin-1 (cav1), the main structural protein of caveolae, is an inhibitor of the TGF-β1 signaling pathway. To examine the role of cav1 in cardiac repair, cav1 deficient (Cav1(-/-)) and wild type (WT) mice were subjected to cryoinjury of the left ventricle (LV). At baseline the two groups exhibited no inflammation, similar collagen content, and similar cardiac function. After injury, Cav1(-/-) animals displayed enhanced TGF-β1 signaling, as reflected by a 3-fold increase in the activation of the Smad2-dependent pathway and more widespread collagen deposition in the heart. Qualitative and quantitative analyses indicated that collagen deposition peaked in the WT LV 14days after injury, accompanied by increased mRNA abundance for procol1a2 (2-fold) and procol3a1 (3-fold). Collagen deposition was further enhanced in Cav1(-/-) mice, which was accompanied by reduced expression of matrix metalloproteinases MMP-8 (3-fold) and -13 mRNA (2-fold). The levels of expression of inflammatory markers of acute phase were similar between the strains However, macrophage clearance in the damaged region was delayed in Cav1(-/-) mice. We observed a 4-fold decrease in collagen deposition in Cav1(-/-) mice injected with a cav1 scaffolding domain peptide (CSD) and a 2-fold decrease in WT mice treated with the CSD. We conclude that cav1 has a direct role in reducing TGF-β1 signaling and as such might be an appropriate target for therapies to influence cardiac remodeling.
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Affiliation(s)
- Shelley K Miyasato
- Dept. of Cell and Molecular Biology, University of Hawaii, John A. Burns School of Medicine, Honolulu, HI, USA.
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Effect of cardiac resynchronization therapy on broad neurohormone biomarkers in heart failure. J Interv Card Electrophysiol 2011; 30:241-9. [DOI: 10.1007/s10840-011-9551-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Accepted: 01/26/2011] [Indexed: 10/18/2022]
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Procollagen III N-terminal peptide predicts short-term prognosis and cardiac remodeling in coronary heart disease patients with metabolic syndrome. Am J Med Sci 2011; 341:10-6. [PMID: 21139493 DOI: 10.1097/maj.0b013e3181f080d8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Many patients with coronary heart disease (CHD) also have metabolic syndrome (MS); however, little is known about the condition of cardiovascular remodeling in these patients. The objective of this study to explore the role of plasma procollagen III N-terminal peptide (PIIINP) in predicting the prognosis and cardiac remodeling in patients with CHD with MS. METHODS One hundred eight patients were classified into high and low PIIINP groups according to the median value of plasma PIIINP. Cardiovascular examinations including echocardiogram, carotid color ultrasound examination, coronary angiography and the 6-minute walking test (6MWT) were performed before and after a 1-year follow-up. Readmission for cardiac and cerebrovascular events was assessed during the follow-up period. RESULTS Plasma PIIINP level was significantly correlated with age, high-sensitivity C-reactive protein (hs-CRP) and body mass index in a multiple stepwise regression model. There was a positive correlation between the LnPIIINP and an increased left ventricular mass index in partial correlation analysis. The Cox proportional hazard model analysis indicated that the level of PIIINP, left ventricular ejection fraction and hs-CRP were independent predictors of readmission owing to cardiac and cerebrovascular events during the follow-up. A PIIINP value of 4.0 μg/L was the best threshold value for determining the need for readmission. CONCLUSIONS PIIINP levels rise with increases in age, hs-CRP and body mass index in patients with CHD with MS, and a high level of PIIINP indicates recent deterioration of cardiac remodeling and exercise tolerance and a poor prognosis.
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Tousoulis D, Andreou I, Tentolouris C, Antoniades C, Papageorgiou N, Gounari P, Kotrogiannis I, Miliou A, Charakida M, Trikas A, Stefanadis C. Comparative effects of rosuvastatin and allopurinol on circulating levels of matrix metalloproteinases and tissue inhibitors of metalloproteinases in patients with chronic heart failure. Int J Cardiol 2010; 145:438-43. [DOI: 10.1016/j.ijcard.2009.05.051] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2009] [Revised: 05/15/2009] [Accepted: 05/22/2009] [Indexed: 10/20/2022]
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Lin YH, Lin C, Lo MT, Lin HJ, Wu YW, Hsu RB, Chao CL, Hsu HC, Wang PC, Wu VC, Wang SS, Lee CM, Chien KL, Ho YL, Chen MF, Peng CK. The relationship between aminoterminal propeptide of type III procollagen and heart rate variability parameters in heart failure patients: a potential serum marker to evaluate cardiac autonomic control and sudden cardiac death. Clin Chem Lab Med 2010; 48:1821-7. [PMID: 20846104 DOI: 10.1515/cclm.2010.348] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Cardiac extra-cellular matrix (ECM) fibrosis plays an important role in the pathophysiology of heart failure (HF). It may provide electrical heterogeneity and a substrate for arrhythmogenicity, which may cause sudden cardiac death (SCD). METHODS Twenty-one patients with manifestations of HF and a left ventricular ejection fraction (LVEF) ≤50% were enrolled. The median age was 62 years and median LVEF was 33%. Time- and frequency-domain analysis of heart rate variability (HRV) on 24 h ambulatory electrocardiography recording was assessed. Serum markers of ECM turnover including type I and III aminoterminal propeptide of procollagen (PINP and PIIINP), matrix metalloproteinase-2 and -9 (MMP-2 and MMP-9), and tissue inhibitor of metalloproteinase-1 (TIMP-1) were analyzed. RESULTS The serum PIIINP concentration was correlated significantly with standard deviation of all normal to normal R-R intervals (SDNN) (r=-0.722, p=<0.001), percentage of adjacent NN interval differences >50 ms (pNN50) (r=-0.528, p=0.014), percentage of adjacent NN interval differences >20 ms (pNN20) (r=-0.545, p=0.002), very low frequency (VLF) (r=-0.490, p=0.024), low frequency (LF) (r=-0.491, p=0.024), and high frequency (HF) (r=-0.513, p=0.018). PINP, MMP-2, -9, TIMP-1 were not correlated with time- and frequency-domain analysis of HRV. CONCLUSIONS PIIINP was significantly correlated with time- and frequency-domain analysis of HRV in HF patients. PIIINP is a potential serological marker to evaluate cardiac autonomic control and risk of SCD in HF patients.
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Affiliation(s)
- Yen-Hung Lin
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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Velagaleti RS, Gona P, Sundström J, Larson MG, Siwik D, Colucci WS, Benjamin EJ, Vasan RS. Relations of biomarkers of extracellular matrix remodeling to incident cardiovascular events and mortality. Arterioscler Thromb Vasc Biol 2010; 30:2283-8. [PMID: 20798380 DOI: 10.1161/atvbaha.110.208462] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To evaluate if biomarkers reflecting left ventricular/vascular extracellular matrix remodeling are associated with cardiovascular disease (CVD) and death in the community. METHODS AND RESULTS In 922 Framingham Study participants (mean age, 58 years; 56% women), we related circulating concentrations of matrix metalloproteinase-9 (binary variable: detectable versus undetectable), log of tissue inhibitor of matrix metalloproteinase-1, and log of procollagen type III aminoterminal peptide (PIIINP) to incident CVD and death. On follow-up (mean, 9.9 years), 51 deaths and 81 CVD events occurred. Each SD increment of log of tissue inhibitor of matrix metalloproteinase-1 and log-PIIINP was associated with multivariable-adjusted hazards ratios of 1.72 (95% CI, 1.30 to 2.27) and 1.47 (95% CI, 1.11 to 1.96), respectively, for mortality risk. Log-PIIINP concentrations were also associated with CVD risk (hazard ratio [95% CI] per SD, 1.35 [1.05 to 1.74]). Death and CVD incidence rates were 2-fold higher in participants with both biomarkers higher than the median (corresponding hazard ratio [95% CI], 2.78 [1.43 to 5.40] and 1.77 [1.04 to 3.03], respectively) compared with those with either or both less than the median. The inclusion of both biomarkers improved the C-statistic (for predicting mortality) from 0.78 to 0.82 (P=0.03). Matrix metalloproteinase-9 was unrelated to either outcome. CONCLUSIONS Higher circulating tissue inhibitor of matrix metalloproteinase-1 and PIIINP concentrations are associated with mortality, and higher PIIINP is associated with incident CVD, in the community.
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Salvianolic acid B functioned as a competitive inhibitor of matrix metalloproteinase-9 and efficiently prevented cardiac remodeling. BMC Pharmacol 2010; 10:10. [PMID: 20735854 PMCID: PMC2940789 DOI: 10.1186/1471-2210-10-10] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Accepted: 08/25/2010] [Indexed: 11/29/2022] Open
Abstract
Background Infarct-induced left ventricular (LV) remodeling is a deleterious consequence after acute myocardial infarction (MI) which may further advance to congestive heart failure. Therefore, new therapeutic strategies to attenuate the effects of LV remodeling are urgently needed. Salvianolic acid B (SalB) from Salviae mitiorrhizae, which has been widely used in China for the treatment of cardiovascular diseases, is a potential candidate for therapeutic intervention of LV remodeling targeting matrix metalloproteinase-9 (MMP-9). Results Molecular modeling and LIGPLOT analysis revealed in silico docking of SalB at the catalytic site of MMP-9. Following this lead, we expressed truncated MMP-9 which contains only the catalytic domain, and used this active protein for in-gel gelatin zymography, enzymatic analysis, and SalB binding by Biacore. Data generated from these assays indicated that SalB functioned as a competitive inhibitor of MMP-9. In our rat model for cardiac remodeling, western blot, echocardiography, hemodynamic measurement and histopathological detection were used to detect the effects and mechanism of SalB on cardio-protection. Our results showed that in MI rat, SalB selectively inhibited MMP-9 activities without affecting MMP-9 expression while no effect of SalB was seen on MMP-2. Moreover, SalB treatment in MI rat could efficiently increase left ventricle wall thickness, improve heart contractility, and decrease heart fibrosis. Conclusions As a competitive inhibitor of MMP-9, SalB presents significant effects on preventing LV structural damage and preserving cardiac function. Further studies to develop SalB and its analogues for their potential for cardioprotection in clinic are warranted.
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Tang WHW. Biomarkers of risk stratification in congestive heart failure: North American view. Biomark Med 2010; 3:443-52. [PMID: 20477515 DOI: 10.2217/bmm.09.52] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
There is broad adoption of various cardiac and noncardiac biomarkers in clinical practices across North America for the diagnosis and management of heart failure. Like any clinical condition, there are several overall objectives in biomarker testing: to establish or refute a diagnosis of heart failure and/or cardiac dysfunction; to understand the underlying pathophysiologic processes that may warrant specific interventions; to determine the level of disease severity in a manner to triage medical decisions; to detect and potentially avoid adverse consequences as a result of therapeutic interventions; and to monitor responses to treatment. While at present no single biomarker can serve all of these objectives, the growing experience with cardiac-specific biomarkers, such as natriuretic peptide and cardiac troponin testing, has allowed clinicians to better identify those at heightened short- or long-term risk. It is clear that difficulty remains in translating research evidence into clinical practice. While studies demonstrate statistical differences in short- and long-term outcomes, there is still limited information on how such improvements can be achieved solely based on current therapeutic options. Meanwhile, many commonly ordered tests have important prognostic information that can be overlooked, yet their changes may or may not affect prognosis. With healthcare cost on the rise in North America, clinical utility of biomarkers must demonstrate relative safety and potential incremental benefits to standard approaches.
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Affiliation(s)
- W H Wilson Tang
- Section of Heart Failure & Cardiac Transplantation Medicine, Department of Cardiovascular Medicine, Heart & Vascular Institute, The Cleveland Clinic, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH 44195, USA.
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Lok DJA, Van Der Meer P, de la Porte PWBA, Lipsic E, Van Wijngaarden J, Hillege HL, van Veldhuisen DJ. Prognostic value of galectin-3, a novel marker of fibrosis, in patients with chronic heart failure: data from the DEAL-HF study. Clin Res Cardiol 2010; 99:323-8. [PMID: 20130888 PMCID: PMC2858799 DOI: 10.1007/s00392-010-0125-y] [Citation(s) in RCA: 362] [Impact Index Per Article: 25.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2009] [Accepted: 01/20/2010] [Indexed: 01/08/2023]
Abstract
Aims Biomarkers are increasingly being used in the management of patients with chronic heart failure (HF). Galectin-3 is a recently developed biomarker associated with fibrosis and inflammation, and it may play a role in cardiac remodeling in HF. We determined its prognostic value in patients with chronic HF. Methods and results Patients with chronic HF (New York Heart Association functional class III or IV) who participated in the Deventer–Alkmaar heart failure study were studied. Galectin-3 levels were determined at baseline using a novel optimized enzyme-linked immunosorbent assay. Univariate and multivariate analyses were used to determine the prognostic value of this biomarker. We studied 232 patients; their mean age was 71 ± 10 years, 72% were male, and 96% were in NYHA class III. During a follow-up period of 6.5 years, 98 patients died. Galectin-3 was a significant predictor of mortality risk after adjustment for age and sex, and severity of HF and renal dysfunction, as assessed by NT-proBNP and estimated glomerular filtration rate, respectively (hazard ratio per standard deviation 1.24, 95% CI 1.03–1.50, P = 0.026). Conclusion Plasma galectin-3 is a novel prognostic marker in patients with chronic HF. Its prognostic value is independent of severity of HF, as assessed by NT-proBNP levels, and it may potentially be used in the management of such patients.
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Kitaoka H, Kubo T, Okawa M, Hayato K, Yamasaki N, Matsumura Y, Doi YL. Impact of Metalloproteinases on Left Ventricular Remodeling and Heart Failure Events in Patients With Hypertrophic Cardiomyopathy. Circ J 2010; 74:1191-6. [DOI: 10.1253/circj.cj-09-1013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Toru Kubo
- Department of Medicine and Geriatrics, Kochi Medical School
| | - Makoto Okawa
- Department of Medicine and Geriatrics, Kochi Medical School
| | - Kayo Hayato
- Department of Medicine and Geriatrics, Kochi Medical School
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Feng W, Li W. The study of ISO induced heart failure rat model. Exp Mol Pathol 2009; 88:299-304. [PMID: 19909738 DOI: 10.1016/j.yexmp.2009.10.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2009] [Revised: 10/16/2009] [Accepted: 10/26/2009] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To find a more excellent large-dose isoproterenol (ISO) induced heart failure (HF) rat model. METHODS 166 male Wistar rats were divided into four groups, normal group (n=10), 85/85 mg/kg group (n=50), 85/340 mg/kg group (n=50) and 340/340 mg/kg group (n=56). HF was induced by two subcutaneous injections of homologous ISO on 2 consecutive days. We calculated death rate of each ISO group on different time points. And all the survival ISO rats were examined by echocardiography separately on 2 weeks, 3 weeks and 4 weeks. We defined the EF<45% rats as heart failure, and calculated EF<45% rate of three ISO groups. 4 weeks after the last injection, all of the rats were sacrificed. H&E and Masson staining were used to evaluate inflammatory infiltration and myocardial fibrosis, and immunohistochemistry was used to measure the levels of IL-1, IL-6 and IL-17. We also treated adult rat cardiac fibroblasts with IL-1, IL-6, IL-17, or PBS for 24 h, and real-time PCR was used to measure the expressions of MMP-2 and MMP-9 in treated fibroblasts. RESULTS Through 4-week observation, we found that the period within 2 days after the last injection was the most dangerous one for all the ISO rats, regardless of injection dose. Then, the death rate increased slowly. 4 weeks later, the death rates were respectively 30% in 85/85 mg/kg group, 60% in 85/340 mg/kg group, and 68% in 340/340 mg/kg group, and there were statistical differences among three experimental groups. Moreover, the EF<45% rate and cardiac fibrosis rate were 100% in 85/340 mg/kg group as same as 340/340 mg/kg group, and much higher than 85/85 mg/kg group. Furthermore, we also found that pro-inflammatory cytokines (IL-1, IL-6 and IL-17) increased in 85/340 mg/kg group compared with normal group, and above cytokines could induce MMP-2 and MMP-9 expression in cardiac fibroblasts. CONCLUSION 85/340 mg/kg ISO induced HF rat model was superior to the other two dose ISO induced HF rat models. Pro-inflammatory cytokines might contribute to HF and myocardial fibrosis through promotion of MMPs expression in cardiac fibroblasts.
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Affiliation(s)
- Weiwei Feng
- Department of Cardiology, The first affiliated hospital of Harbin Medical University, Harbin, P R China, 150001
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Natural history of markers of collagen turnover in patients with early diastolic dysfunction and impact of eplerenone. J Am Coll Cardiol 2009; 54:1674-82. [PMID: 19850207 DOI: 10.1016/j.jacc.2009.08.021] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2009] [Revised: 08/26/2009] [Accepted: 08/31/2009] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This study was designed to evaluate the impact of eplerenone on collagen turnover in preserved systolic function heart failure (HFPSF). BACKGROUND Despite growing interest in abnormal collagen metabolism as a feature of HFPSF with diastolic dysfunction, the natural history of markers of collagen turnover and the impact of selective aldosterone antagonism on this natural history remains unknown. METHODS We evaluated 44 patients with HFPSF, randomly assigned to control (n = 20) or eplerenone 25 mg daily (n = 24) for 6 months, increased to 50 mg daily from 6 to 12 months. Serum markers of collagen turnover and inflammation were analyzed at baseline and at 6 and 12 months and included pro-collagen type-I and -III aminoterminal peptides, matrix metalloproteinase type-2, interleukin-6 and -8, and tumor necrosis factor-alpha. Doppler-echocardiographic assessment of diastolic filling indexes and tissue Doppler analyses were also obtained. RESULTS The mean age of the patients was 80 +/- 7.8 years; 46% were male; 64% were receiving an angiotensin-converting enzyme inhibitor, 34% an angiotensin-II receptor blocker, and 68% were receiving beta-blocker therapy. Pro-collagen type-III and -I aminoterminal peptides, matrix metalloproteinase type-2, interleukin-6 and -8, and tumor necrosis factor-alpha increased with time in the control group. Eplerenone treatment had no significant impact on any biomarker at 6 months but attenuated the increase in pro-collagen type-III aminoterminal peptide at 12 months (p = 0.006). Eplerenone therapy was associated with modest effects on diastolic function without any impact on clinical variables or brain natriuretic peptide. CONCLUSIONS This study demonstrates progressive increases in markers of collagen turnover and inflammation in HFPSF with diastolic dysfunction. Despite high background utilization of renin-angiotensin-aldosterone modulators, eplerenone therapy prevents a progressive increase in pro-collagen type-III aminoterminal peptide and may have a role in management of this disease. (The Effect of Eplerenone and Atorvastatin on Markers of Collagen Turnover in Diastolic Heart Failure; NCT00505336).
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Lin YH, Lin LY, Wu YW, Chien KL, Lee CM, Hsu RB, Chao CL, Wang SS, Hsein YC, Liao LC, Ho YL, Chen MF. The relationship between serum galectin-3 and serum markers of cardiac extracellular matrix turnover in heart failure patients. Clin Chim Acta 2009; 409:96-9. [DOI: 10.1016/j.cca.2009.09.001] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2009] [Revised: 07/14/2009] [Accepted: 09/02/2009] [Indexed: 01/13/2023]
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Abstract
The extracellular cardiac matrix (ECCM) plays an important role in the support of myocytes and fibroblasts. ECCM turnover is influenced by ischemia, stretch, inflammation, and neurohormonal mediators. Myocardial fibrosis is the consequence of several pathologic processes mediated by mechanical, neurohormonal, and cytokine factors. It is a major determinant of diastolic dysfunction and pumping capacity and may result in tissue heterogeneity, dys-synchrony, and arrhythmias. The measurement of various serum peptides arising from the metabolism of collagen types 1 and 3, of degradation fragments, and of specific metalloproteinases may provide noninvasive assessment of fibrosis. ECCM biomarkers are clinically useful tools, particularly given the potential for cardioprotective and cardioreparative pharmacologic strategies.
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Affiliation(s)
- Faiez Zannad
- Hôpital Jeanne d'Arc, Dommartin-les-Toul, France
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Deardorff R, Spinale FG. Cytokines and matrix metalloproteinases as potential biomarkers in chronic heart failure. Biomark Med 2009; 3:513-523. [PMID: 20161487 DOI: 10.2217/bmm.09.60] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Heart failure (HF) is accompanied by the upregulation of bioactive signaling molecules, known as cytokines, and a family of downstream proteases, matrix metalloproteinases (MMPs). It is now apparent that these molecules contribute to adverse myocardial remodeling during HF. Elevated levels of cytokines and MMPs exist in the myocardium and can subsequently spill over into the systemic circulation. The purpose of this article is to examine clinical studies of HF that have quantified levels of different types of cytokines, MMPs and endogenous tissue inhibitors of MMPs in relation to this disease process. HF is a complex syndrome that can develop from various etiologies and can be characterized into two distinct phenotypes: systolic and diastolic. This article will present recent clinical studies that have identified significant differences between the cytokine and MMP circulating profile of systolic and diastolic HF patients. In general, elevated levels of cytokines and MMPs exist in systolic HF patients when compared with diastolic HF patients, whereas diastolic HF patients have elevated levels of cytokines and MMPs when compared with controls. Therefore, future studies distinguishing between HF phenotypes may provide more consistent results in determining possible analytes to be used as biomarkers. Furthermore, this article will emphasize why standardization of analytical techniques and establishment of referent cytokine and MMP levels are necessary if these analytes are to be used as biomarkers for the diagnosis, prognosis and evaluation of treatment in the context of HF.
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